Provider Demographics
NPI:1417136052
Name:MOROFF, MEREDITH L (MD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:L
Last Name:MOROFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 LAKEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-5839
Mailing Address - Country:US
Mailing Address - Phone:631-935-8217
Mailing Address - Fax:631-676-5214
Practice Address - Street 1:711 NEREID AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-1201
Practice Address - Country:US
Practice Address - Phone:631-935-8217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA115907002084P0800X
NY2332702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty